Influence of Occult Hepatitis B Virus Coinfection on the Incidence of Fibrosis and Hepatocellular Carcinoma in Chronic Hepatitis C
Influence of Occult Hepatitis B Virus Coinfection on the Incidence of Fibrosis and Hepatocellular Carcinoma in Chronic Hepatitis C
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DOI：
10.1159/000187720
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发表时间：
2008-01-01
期刊：
影响因子：
4.6
通讯作者：
Moriyama, Mitsuhiko
中科院分区：
文献类型：
--
作者：
Matsuoka, Shunichi;Nirei, Kazushige;Moriyama, Mitsuhiko
我们前瞻性研究了隐匿性B型肝炎病毒（HBV）感染对HCV RNA阳性慢性肝炎（CH-C）组织病理学特征和临床结局的影响，并检测了肝细胞中的B型肝炎核心（HBc）颗粒。本文对468例血清B型肝炎表面抗原（HBsAg）酶联免疫吸附试验阴性的慢性丙型肝炎（CH-C）和肝硬化（LC）患者进行了血清学检查。用巢式PCR检测血清HBV DNA。应用免疫组化技术及光镜、电镜观察肝内HBsAg和HBc抗原（HBcAg）。43.6%的患者血清HBV DNA阳性。HBV DNA阳性和DNA阴性患者的临床特征无显著差异。对于HBV DNA阳性患者，炎性细胞浸润和肝细胞不规则再生的程度明显大于HBV DNA阴性患者。HBV DNA阳性患者发生肝细胞癌（HCC）的累积概率显著高于HBV DNA阴性患者。多因素分析显示HBV DNA阳性是HCC发生的危险因素。HBsAg和HBcAg分别在8.5%和72.3%的血清HBV DNA阳性个体的肝脏中检出。通过IEM在肝细胞核中检测到核心颗粒。隐匿性HBV感染可影响CH-C或LC的组织病理学特征和长期预后。版权所有（C）2009 S. Karger AG，巴塞尔
We examined prospectively the influence of occult hepatitis B virus (HBV) infection on the histopathological features and clinical outcome of HCV RNA-positive chronic hepatitis (CH-C) and detected hepatitis B core (HBc) particles in hepatocytes. The subjects were 468 patients with CH-C or liver cirrhosis (LC) who were negative for serum hepatitis B surface antigen (HBsAg) by enzyme-linked immunosorbent assay. HBV DNA was detected in serum by nested PCR. HBsAg and HBc antigen (HBcAg) in liver were investigated using immunohistochemical techniques and light (LM) and electron microscopy (EM). Serum HBV DNA was detected in 43.6% of the patients studied. There were no significant differences between HBV DNA-positive and DNA-negative patients in terms of their clinical profiles. For HBV DNA-positive patients, the degree of inflammatory cell infiltration and irregular regeneration of hepatocytes was significantly greater than for HBV DNA-negative patients. The cumulative probability of development of hepatocellular carcinoma (HCC) was significantly higher for HBV DNA-positive patients than for HBV DNA-negative patients. HBV DNA positivity was a risk factor for the occurrence of HCC according to multivariate analysis. HBsAg and HBcAg were detected in 8.5 and 72.3%, respectively, of the livers of serum HBV DNA-positive individuals. Core particles were detected in the nuclei of the hepatocytes by IEM. The histopathological features and long-term outcome of CH-C or LC could be affected by occult HBV infection. Copyright (C) 2009 S. Karger AG, Basel